[Objective] To analyze the serological characteristics and molecular biology results for a P^k phenotype. [Methods] One patient with P^k phenotype upon unexpected antibodies at Jining Blood Center in July 2022 was selected as the study subject. The blood groups and unexpected antibodies of the proband and his second son were identified using serological methods. The sequences of 3-β-N-acetylgalactosaminyltransferase gene (B3GALNT1) and the coding region of α-1,4-galactosyltransferase gene (A4GALT) were amplified and analyzed by PCR direct sequencing, and haploid sequence analysis was carried out on the variant sites of the B3GALNT1 gene. PROVEAN, SIFT, PolyPhen2 and Mutation Taster were used to analyze the effect of mutations on the protein. [Results] Serological test results suggested that the proband was a P2^k type, including anti-P antibody in his serum, and his son was the P2 phenotype. Sequencing analysis revealed that the proband had a compound heterozygous variants of the B3GALNT1 in c. 239T>A (p. Leu80Gln) and c. 433C>T (p. Arg145Ter). Further haploid analysis showed that the c. 239T>A had occurred in one haploid while c. 433C>T was present in the other haploid, and his son carried a heterozygous variant of c. 433C>T (p. Arg145Ter); the proband and his son all have homozygous mutation variants of the A4GALT in c. 903C>G. Bioinformatic analysis also predicted that the mutations were harmful to the protein function. [Conclusion] The compound heterozygous variants c. 239T>A (p. Leu80Gln) and c. 433C>T (p. Arg145Ter) in the B3GALNT1 gene may contribute to the P^k phenotype, of which the c. 239T>A variant has not been reported.

AIM: To compare the outcome of C3F8 versus silicone oil tamponade after pars plana vitrectomy(PPV)and inverted internal limiting membrane(ILM)for the treatment of highly myopic macular hole retinal detachment(MHRD).METHODS: Retrospective clinical study. Totally 45 patients(45 eyes)with highly myopic MHRD who visited our hospital between January 2019 and August 2022 were selected as the research subjects. The patients were divided into two groups according to different intraocular tamponade agents: C3F8(22 eyes)and silicone oil(23 eyes)groups. All patients underwent conventional three-incision PPV, ILM was tamped, a venous blood clot was placed on the tamped ILM, and 15% C3F8 and silicone oil were used as tamponade, respectively. The best corrected visual acuity(BCVA), multifocal electroretinogram(mfERG), the closure of the macular hole, retinal reattachment and the complications were observed.RESULTS: The macular hole closure rate was 77% in the C3F8 group and 83% in the silicone oil group, respectively(P>0.05), and retinal reattachment rates were 95% and 96%, respectively(P>0.05). The visual acuity of the two groups significantly improved, which was 0.99±0.34 and 1.22±0.37, respectively, and the C3F8 group was better than that of the silicone oil group(t=-2.156, P=0.037). After operation, the response density of the first ring of P1 wave in the first order kernel in mfERG was 114.27±26.37 nV/deg2 for the C3F8 group and 98.08±24.36 nV/deg2 for the silicone oil group, and the response density of the second ring of P1 wave was 80.45±14.94 nV/deg2 for the C3F8 group and 67.73±15.33 nV/deg2 for the silicone oil group, all of which were significantly higher compared to pre-operation [the response density of the first ring of P1 wave: 58.13±13.96 nV/deg2 for the C3F8 group and 55.30±10.48 nV/deg2 for the silicone oil group, the response density of the second ring of P1 wave: 51.18±8.19 nV/deg2 for the C3F8 group and 47.43±11.97 nV/deg2 for the silicone oil group](all P<0.05). It was found that the response density of the first ring of P1 wave was lower in the silicone oil group than in the C3F8 group(P<0.05). There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).CONCLUSION: Silicone oil tamponade or C3F8 tamponade after PPV combined with ILM can both promote retinal reattachment and macular hole closure in patients with MHRD, and the C3F8 tamponade was superior to silicone oil in visual function recovery.

Objective To explore the doctor's willingness to adopt artificial intelligence aided diagnosis and treatment system(ADTS)and its influencing factors,clarify the key links in the implementation of ADTS,and then propose suggestions for optimizing technology and management.Methods On the basis of UTAUT model,factors such as perceived risk,cognitive trust and legal supervision were added to design a questionnaire.After pre-investigation,226 officially recovered questionnaire data were analyzed for reliability and validity,hypothesis testing and SEM fitting,and the relationship chain model of doctors'ADTS adoption intention was obtained.Results Performance expectation,cognitive trust and social influence have a direct positive impact on doctors'willingness,among which social influence has the greatest effect.Facilitating conditions and legal supervision have indirect influence.It also found that doctors who have used ADTS have higher scores in various aspects such as performance expectations,effort expectations,and learning adaptability.Conclusion To implement the application of ADTS,attention should be paid to training,the software and hardware operation and maintenance system,and risk responsibility regulations should be improved,requiring joint efforts from multiple parties.

Objective To explore the doctor's willingness to adopt artificial intelligence aided diagnosis and treatment system(ADTS)and its influencing factors,clarify the key links in the implementation of ADTS,and then propose suggestions for optimizing technology and management.Methods On the basis of UTAUT model,factors such as perceived risk,cognitive trust and legal supervision were added to design a questionnaire.After pre-investigation,226 officially recovered questionnaire data were analyzed for reliability and validity,hypothesis testing and SEM fitting,and the relationship chain model of doctors'ADTS adoption intention was obtained.Results Performance expectation,cognitive trust and social influence have a direct positive impact on doctors'willingness,among which social influence has the greatest effect.Facilitating conditions and legal supervision have indirect influence.It also found that doctors who have used ADTS have higher scores in various aspects such as performance expectations,effort expectations,and learning adaptability.Conclusion To implement the application of ADTS,attention should be paid to training,the software and hardware operation and maintenance system,and risk responsibility regulations should be improved,requiring joint efforts from multiple parties.

Objective:To investigate the clinical efficacy of subcutaneous asymmetric tension reduction combined with dermal buried angular mattress suture in surgical treatment of benign pigmented facial lesions in infants and preschoolers.Methods:Totally, 100 infants and preschoolers with pigmented facial lesions were enrolled from the Department of Dermatology, Hanzhong Central Hospital and the Second Affiliated Hospital of Xi′an Jiaotong University from January 2018 to January 2019, and their clinical data were analyzed retrospectively. Among these patients, there were 59 males and 41 females, and their age ranged from 3 months to 5 years, with an average age of 15 months. All patients underwent outpatient surgery under local anesthesia, and sedative drugs were used before operation. The skin lesions were excised once or in stages according to their areas, and incisions were closed by using a subcutaneous asymmetric suture-based tension reduction technique, followed by dermal buried angular mattress sutures. After surgery, medical silicone gels and tension reduction devices were used for 6 months to 1 year, and postoperative follow-up was performed.Results:All patients were followed up for more than 1 year after surgery. Four patients showed suture rejection reaction within two months after surgery, and the incisions completely healed after the suture knots were discharged; cat′s ear-shaped scars were formed at the upper and lower ends of the incisions in 3 cases when the sutures were removed 1 week after surgery, no treatment was given, and the cat′s ear-shaped scars gradually became flat after 1 year of follow-up; fat liquefaction occurred in 1 case 4 days after surgery, re-suturing of the incision was done 1 week after the removal of internal sutures and drainage, and the incision healed well; 1 case developed infection 3 days after surgery, and then received the removal of internal sutures, drainage, and anti-infection treatment, re-suturing was performed after complete regression of the incision swelling, and the incisions healed well; scar hyperplasia occurred in 4 cases 3 to 6 months after surgery, and the scars became flat after the local injection of triamcinolone acetonide. In the remaining children, fine white linear scars were formed after the healing of incisions, the depressions and ridges at both ends of the incisions became flat, and there was no obvious pulling sensation in facial organs or formation of cat′s ear-shaped scars.Conclusions:Subcutaneous asymmetric tension reduction combined with dermal buried angular mattress suture can effectively reduce tension twice during delicate facial surgery in infants and preschoolers, and help to avoid incision widening and scar hyperplasia. The follow-up showed favorable long-term efficacy and aesthetic effect.

Objective To analyzes the influence of Artificial Intelligence(AI)technology on physician workload based on the panel data of 31 provinces in China from 2012 to 2021.Methods Using MATLAB R2022b software to estimate the kernel density of physician workload and analyze the changes of physician workload in the past 10 years.Select fixed effects model and perform panel regression analysis between AI techniques and physician workload based on Stata MP 17.0 software.Results At present,there is a serious regional multi-level differentiation in physician workload.AI-assisted diagnosis,AI-assisted treatment and AI-assisted management have significantly reduced the physician workload.However,there is regional difference in the negative influence of AI technology on physician workload,with the most significant influence in eastern China and less significant in western China.Both aging and personal health investment negatively moderate the relationship between AI-assisted diagnosis technology and physician workload.Conclusion Great attention should be paid to AI,especially AI-assisted diagnosis technology,because it plays an important role in reducing the physician workload and alleviating the pressure caused by insufficient medical resources and uneven distribution in the context of aging.

Objective To investigate the mechanism of RNF7 for regulating myeloid-derived suppressor cells(MDSCs)in non-small cell lung cancer(NSCLC).Methods TIMER2.0 database and immunohistochemistry were used to analyze RNF7 expression level and its correlation with immune cell infiltration in non-small cell lung cancer.The impact of RNF7 expression levels on prognosis of lung cancer patients was analyzed using Kaplan-Meier survival analysis.CMT-167 cells with RNF7 overexpression or knockdown were inoculated subcutaneously in C57BL/6 mice,and the mice in RNF7 knockdown group were treated with anti-PD-1 or IgG isotype control 7 days after the inoculation.The tumor tissues were harvested after 30 days for tumor volume measurement,detection of S100A8+A9 and Gr-1 expressions with immunohistochemistry,and analysis of MDSC infiltration.Gene set enrichment analysis(GSEA)was performed to identify the potential pathways regulated by RNF7 in NSCLC.Western blotting and luciferase assays were used to assess the impact of RNF7 on the NF-κB signaling pathway.ELISA and RT-qPCR were used to measure chemokine(C-X-C motif)ligand 1(CXCL1)expression.Results RNF7 expression was significantly upregulated in NSCLC,and high RNF7 expression levels were associated with poor prognosis of the patients(P<0.001).TIMER2.0 analysis revealed a positive correlation between RNF7 expression and MDSC infiltration(P<0.001).GSEA suggested that RNF7 was enriched in the NF-κB signaling pathway.In NSCLC cells,RNF7 knockdown significantly inhibited NF-κB activation and reduced CXCL1 expression.In the tumor-bearing mice,RNF7 overexpression significantly increased MDSC infiltration in the tumor tissue,and RNF7 knockdown obviously reduced MDSC infiltration and enhanced the efficacy of anti-PD-1 therapy.Conclusion High expression of RNF7 in NSCLC cells promotes CXCL1 expression by activating the NF-κB signaling pathway,thus leading to the chemotactic recruitment of MDSCs,which contributes to tumor resistance to anti-PD-1 therapy.

Objective To observe the clinical efficacy of self-formulated Shenqi Buwei Decoction(derived from Huangqi Renshen Decoction)in treating patients with stable chronic obstructive pulmonary disease(COPD)differentiated as lung-spleen qi deficiency syndrome.Methods A total of 110 patients with stable COPD differentiated as lung-spleen qi deficiency syndrome were randomly divided into a control group and an observation group,with 55 patients in each group.The control group was given Tiotropium Bromide Inhalation Powder for the inhalation treatment,and the observation group was given Shenqi Buwei Decoction on the basis of treatment for the control group,and the course of treatment covered 3 months.The changes of pulmonary function indicators of forced expiratory volume in one second(FEV1),forced vital capacity(FVC),and one-second rate of FEV1/FVC,modified Medical Research Council index(mMRC)dyspnea scores,6-minute walk test(6MWT),COPD Assessment Test(CAT)scores,and traditional Chinese medicine(TCM)syndrome scores in the two groups were observed before and after treatment.After treatment,the clinical efficacy and safety of the two groups were evaluated.Results(1)During the trial,one patient was excluded and two patients fell off from the observation group,and three patients fell off from the control group.Eventually,52 patients in each of the two groups were included in the efficacy statistics.(2)After 3 months of treatment,the total effective rate of the observation group was 80.77%(42/52)and that of the control group was 67.31%(35/52).The intergroup comparison(tested by chi-square test)showed that the therapeutic effect of the observation group was slightly superior to that of the control group,but the difference was not statistically significant(P＞0.05).(3)In terms of indexes,After treatment,the levels of pulmonary function indicators of FEV1,FEV1/FVC in the control group and FEV1,FVC,FEV1/FVC in the observation group were significantly improved compared with those before treatment(P＜0.05),and the improvement of FEV1,FVC,FEV1/FVC in the observation group was significantly superior to that in the control group(P＜0.05).(4)After treatment,the 6MWT,mMRC and CAT scores of the two groups were significantly improved compared with those before treatment(P＜0.05),and the improvement in the observation group was significantly superior to that in the control group(P＜0.05).(5)After treatment,the TCM syndrome scores of the two groups of patients were significantly decreased in comparison with those before treatment(P＜0.05),and the decrease in the observation group was significantly superior to that in the control group(P＜0.05).(6)During the treatment process,no obvious adverse reactions occurred in the two groups of patients,there were no abnormal changes in the safety indicators,either.Conclusion On the basis of conventional western medicine treatment,the combined use of Shenqi Buwei Decoction exerts certain efficacy in the treatment of patients with stable COPD differentiated as lung-spleen qi deficiency syndrome.The combined therapy can effectively improve the ventilation function,relieve the clinical symptoms,improve the quality of life and delay the decline of lung function of the patients.

Objective To explore the doctor's willingness to adopt artificial intelligence aided diagnosis and treatment system(ADTS)and its influencing factors,clarify the key links in the implementation of ADTS,and then propose suggestions for optimizing technology and management.Methods On the basis of UTAUT model,factors such as perceived risk,cognitive trust and legal supervision were added to design a questionnaire.After pre-investigation,226 officially recovered questionnaire data were analyzed for reliability and validity,hypothesis testing and SEM fitting,and the relationship chain model of doctors'ADTS adoption intention was obtained.Results Performance expectation,cognitive trust and social influence have a direct positive impact on doctors'willingness,among which social influence has the greatest effect.Facilitating conditions and legal supervision have indirect influence.It also found that doctors who have used ADTS have higher scores in various aspects such as performance expectations,effort expectations,and learning adaptability.Conclusion To implement the application of ADTS,attention should be paid to training,the software and hardware operation and maintenance system,and risk responsibility regulations should be improved,requiring joint efforts from multiple parties.

Objective To explore the doctor's willingness to adopt artificial intelligence aided diagnosis and treatment system(ADTS)and its influencing factors,clarify the key links in the implementation of ADTS,and then propose suggestions for optimizing technology and management.Methods On the basis of UTAUT model,factors such as perceived risk,cognitive trust and legal supervision were added to design a questionnaire.After pre-investigation,226 officially recovered questionnaire data were analyzed for reliability and validity,hypothesis testing and SEM fitting,and the relationship chain model of doctors'ADTS adoption intention was obtained.Results Performance expectation,cognitive trust and social influence have a direct positive impact on doctors'willingness,among which social influence has the greatest effect.Facilitating conditions and legal supervision have indirect influence.It also found that doctors who have used ADTS have higher scores in various aspects such as performance expectations,effort expectations,and learning adaptability.Conclusion To implement the application of ADTS,attention should be paid to training,the software and hardware operation and maintenance system,and risk responsibility regulations should be improved,requiring joint efforts from multiple parties.